New Cancer Diagnoisis

[Sheshe]

We found out last night the Bella has Osteo. The Dr. gave several options with varying results. At the point we are considering pain management. Has anyone gone this route and how it worked vs amputation. Beacuse of where the cancer is both are good options but the amputation does not give any longer of life span than the pain management.

[TheFullHouse]

I'm so sorry.

[Charlies_Dad]

I'm very sorry to read of Bella's diagnosis. I suggest you look at the Osteo thread in H&M as there is a lot in there. Jen (aka Neylasmom) went the pain management path and was able to help give Neyla many months of enjoyment. Also FedX is another pup who is 12mths post dx and is on pain management. I am forgetting his mum's name they both post in the Osteo thread.

[MaryJane]

I'm so sorry about the diagnosis - it's one that I have heard twice before .

 

I could be wrong, but something sounds off - usually amputation is done with chemo and would give a longer possibility then just pain management - was that mentioned at all?

[vjgrey]

I'm so, so sorry. I was a wreck the first few days after Gabe's diagnosis. I did feel better once we had a plan.

 

Amputation wasn't an option for him (Osteo in two limbs) so we're doing chemo, radiation and four types of pain meds. The radiation has made a huge difference for him. Without it, we would've had to let him go a week after diagnosis. He's now three months post-diagnosis and doing well.

[sabrina]

No advice to give you but wish Belle the best result with whatever course you take

[GreyPoopon]

I'm sorry.

 

I've had two with OS. Cora's didn't show up on the x-rays until the only thing holding her leg together was the plate used to repair her fracture. It was too late. Tally was diagnosed when she suddenly went lame. I used pain management for her. We started with an NSAID. When the limp recurred, we added Tramadol, and gradually increased the dosage. We also monitored with x-rays to make sure the bone wasn't becoming too fragile. Eventually, she was dead lame despite the pain meds, and I let her go.

[4My2Greys]

I've not been in your shoes so I can't offer any advice. My thoughts will be with you and Bella though whatever path you choose. I'm so sorry your facing this.

[Houndtime]

I am sorry that I cannot offer any first hand help, but just wanted to say I am sorry to read the diagnosis.

[45MPHK9]

We went the pain management route with Bee Wiseman.

 

She started with Tramadol. We added Deramaxx. Later, we added Gabapentin. When the limp reappeared after big doses of those drugs, we let her go. She died eight weeks after being diagnosed. We crammed lots of fun things into those eight weeks.

 

If amputation could have cured her of cancer, we would have gone that route. It couldn't, so we didn't.

 

I'm so sorry that Bella facing osteo.

[MP_the4pack]

Damn, another one.

 

I'm sorry to hear the news.

 

I went the amp route with a 12 yr old. The biggest reason I chose that over pain management is a big fear of her breaking her leg when I was at work.

[giadog]

I'm so sorry, Sheshe. We're in the same boat as you right now, just got the diagnosis. We haven't decided on which route to take, but I wish you and Bella nothing but warmth and love.

[Guest snakes]

HI, FedX's mom here.

I am sorry to hear of your pups diagnosis (and giadogs too if she is reading).

I am doing palliative care (pain and quality of life management) for FedX who has osteo in his front left distal radius. I decided on palliative care due to his other medical conditions and the costs of amputation. Personally I don't ever want to do chemo for him either.

So we have pain medication. The most helpfull for him was gabapentin, he is also on Novox (generic rimadyl) to keep the inflammation down. I give tramdol on an "as needed" basis on days when his pain is worse.

I tried palliative radiation once but his pain became significantly worse so we never had more. This treatment has worked wonders for some of the other pups.

We do Pamidronate infusions which are IMMENSELY helpful, i noticed his pain decreased within 24hrs, he has now had the recommended 6 doses and we just go every 3 months to keep the pain in check. It is expensive ($350+$50bloodwork) and each treatment takes 3-4hrs.

 

I am also treating him with a chinese herb mixture, curcumin, and artemisinin.

 

So far we are at 13months post diagnosis and still doing well! A mixture of pure luck and pain management.

It is a rollercoaster that never stops, if you need any more details of our regimen or experience, feel free to PM me.

[NeylasMom]

Where is the cancer? And did your vet give you an indication of how far progressed it is? It's hard for vets to give you a clear answer on that, but one thing you can ask to get a better idea is how much of the bone has been eaten away. Generally in the earlier stages you won't see much deterioration of the bone. If it's more progressed, there will be a large dark or moth eaten area on the x-ray.

[duncan41]

FWIW: If you decide to go with pain management, please ask for a referral to an oncologist. In my experience, most Vets do not have the experience/knowledge or intestinal fortitude to prescribe pain medication combinations at appropriate dosages to control pain. So many states are on a witch hunt for narcotic prescriptions writers that even Vets are afraid to prescribe appropriately. My former Vet's office told me that they probably wouldn't be able to refill my prescription because "it's a controlled substance". Seriously? The dog is dying and they were worried about creating an dog drug addict?

 

 

[vjgrey]

So many states are on a witch hunt for narcotic prescriptions writers that even Vets are afraid to prescribe appropriately. My former Vet's office told me that they probably wouldn't be able to refill my prescription because "it's a controlled substance". Seriously? The dog is dying and they were worried about creating an dog drug addict?

 

Unfortunately, oncology offices seem to be worried about that, too. Or at least mine does. I have to really push to get more than exactly a week's worth of Tramadol for Gabe. Normally that's fine because his appointments are generally once a week, but sometimes they're not, and sometimes he needs a little extra to control his pain (e.g super cold days). They're always very hesitant to give me more.

 

Edited to add - I'm generally very happy with his oncology office and strongly agree that you need a specialist if you have one in your area.

Edited February 16, 2012 by vjgrey

[Sheshe]

My regular vet due to the fact that my Ami needed the tramadol before he died sold us a bottle of 1000 of 50mg. So I am set on Tramadol. The combination the ortho gave was

Previcox 1/2 of a 227mg a day. Up to 150 tramadol three times a day, and one Fosimax a day. He did say to follow up with an oncologist and gave me a #. She is in wonderful spirits right now, kissing me wanting to play. It is me who is a wreck. I haven't stoppred crying since I saw the x-ray yesterday. My head hurts, my eyes are swollen. I just lost my Amadeus in December and now my Bella Rose. I am praying for a very long time with her but will be realistic.

Thanks for all the well wishes and the info. This is a wonderful place to get wonderful information.

Sheila

[joejoesmom]

I am so sorry you are facing this too.

 

I did want to say that there appears to be some confusion with the survival times of palliative care vs. amputation or amputation/chemo.

 

The following median times of survival are quoted by Ohio State University. In case you weren't aware, OSU is a leading researcher of bone cancer in greyhounds.

 

Palliative care alone (pain control); 1 1/2 to 3 months

Amputation alone: 3 to 6 months

Amputation followed by IV chemo: 12 to 14 months (they are currently quoting 14 months for a greyhound)

 

They do not yet have greyhound specific data for other non-amputation treatments, but they quoted me the following:

 

No amputation but 4 courses of radiation: 4 to 8 months

No amputation but 4 courses of radiation and IV chemo: 6 to 9 months

 

I did not get a median time of survival for adding pamidronate infusions to the radiation and/or chemo.

 

Amputation, chemo, radiation, and pamidronate are all fairly expensive.

 

You can see this recent thread for more information on treatments and their costs:

 

http://forum.greytalk.com/index.php/topic/283076-amputation-insight/

 

So in summary, amputation with chemo has the longest median time of survival. However, not all dogs are capable of handling amputation due to other health issues. In addition, the cost of amputation and chemo can be prohibitive. There is absolutely nothing wrong with this being a factor. Dogs live in the moment. They don't think about how long they are going to live or worry about the future. All they care about is whether they are happy, loved, well fed, and not in significant pain. So in a way, doing more aggressive treatment to provide a longer, high quality life is as much for the human as the dog, probably more.

 

If you do go the palliative route, be sure you have a vet who is good at pain management. A typical drug regimen for a greyhound with bone cancer includes an NSAID (Deramaxx, Rimadyl, meloxicam, etc.), an opiate like pain killer (often tramadol is used), and gabapentin (Brand name Neurontin) which helps nerve pain. Be sure you know how much you can increase the medications in case your dog has a jump in pain at a time when the vet is not available (nights, weekends, etc.). Have a plan in place if your dog has a fracture.

 

Lastly, make lots of memories. Enjoy each other, take pictures, etc.

 

I so hate the rat b*st*rd osteo. It needs to be wiped from the face of the earth.

 

Jane

[Guest snakes]

I concur with everything JoeJoesmom said.

Also, to keep costs more affordable, price the medications out at human pharmacies. I go to our local Walgreens (it was the same price as Walmart just a bit more convenient) for both tramadol (180 50mg tabs for $22) and gabapentin (300 100mgcapsules for $14) and for a very decent price. I haven't encountered any problems with them writing or supplying those scripts (my vet has been amazing and way better than the oncologists).

 

Something that came up awhile ago in the Osteo thread was that you should ask the prescribing vet what dosages you can go up to because unfortunately with any pup they always seem to be in more pain or have something happen at night, weekends, or holidays when the vets aren't available!

[DonnaBehr]

My regular vet due to the fact that my Ami needed the tramadol before he died sold us a bottle of 1000 of 50mg. So I am set on Tramadol. The combination the ortho gave was

Previcox 1/2 of a 227mg a day. Up to 150 tramadol three times a day, and one Fosimax a day. He did say to follow up with an oncologist and gave me a #. She is in wonderful spirits right now, kissing me wanting to play. It is me who is a wreck. I haven't stoppred crying since I saw the x-ray yesterday. My head hurts, my eyes are swollen. I just lost my Amadeus in December and now my Bella Rose. I am praying for a very long time with her but will be realistic.

Thanks for all the well wishes and the info. This is a wonderful place to get wonderful information.

Sheila

 

Sheila, Red has been on 1/2 of a 227mg Previcox for the last 6 years. Fortunately, this is for severe arthritis that he got at a young age. Given with food it is has been very easy on his stomach and I've had no liver issues. He also gets 1/2 of a 50mg tramadol twice a day.

Praying that Bella can be kept pain-free for a long time.

[carronstar]

It is me who is a wreck. I haven't stoppred crying since I saw the x-ray yesterday. My head hurts, my eyes are swollen. I just lost my Amadeus in December and now my Bella Rose. I am praying for a very long time with her but will be realistic.

 

You have already gotten great information regarding palliative care for Bella. I certainly can't improve on anything that has been said here. I do want to say, try to remember to take care of yourself as well. We all take care of our pups with little or no regard to the cost to ourselves. I am guilty of this as well. Just saying "try" to remember to take care of yourself as well. You may well need meds for this time as well. Even an Advil to releave the headaches and some allergy pills to help your swollen eyes. Try to remember that you and Bella are surrounded by lots of good thoughts, prayers and love.

[Sheshe]

It is me who is a wreck. I haven't stoppred crying since I saw the x-ray yesterday. My head hurts, my eyes are swollen. I just lost my Amadeus in December and now my Bella Rose. I am praying for a very long time with her but will be realistic.

 

You have already gotten great information regarding palliative care for Bella. I certainly can't improve on anything that has been said here. I do want to say, try to remember to take care of yourself as well. We all take care of our pups with little or no regard to the cost to ourselves. I am guilty of this as well. Just saying "try" to remember to take care of yourself as well. You may well need meds for this time as well. Even an Advil to releave the headaches and some allergy pills to help your swollen eyes. Try to remember that you and Bella are surrounded by lots of good thoughts, prayers and love.

 

Thank you, I am resting in today. My Dr. know what I am going through and is very supportive as is my hubby. Funny thing is I have been out of work since June and have had to nurse two dogs. I am sort of glad I am not working now as it gives me time to focus on Bella. Ami I let go in December.

[sweetdogs]

Unfortunately, oncology offices seem to be worried about that, too. Or at least mine does. I have to really push to get more than exactly a week's worth of Tramadol for Gabe.

That's appalling.

 

To the OP, I'm very sorry about Bella's diagnosis. I did radiation & pamidronate for my girl in addition to tramadol, metacam & gabapentin. She couldn't tolerate artemisinin but many hounds can. As Donna mentioned, it's important to keep her stomach healthy by being careful with the NSAID. You may need pepcid & sucralfate if she starts missing meals (& of course watch out for serious digestive upset). My girl did well with all this & it gave us some additional months. I had to let her go when she threw a clot & started to loose her back end (tumor was in her shoulder). I wish you lots of time with her - each hound is different so keep that in mind as you work out a treatment plan for her. If something isn't working, try something else. Very best wishes for you & Bella.